Each morning we woke up at 6 AM to the sound of birds chirping and wind in the trees. This time for breakfast there was beans with rice mixed in, thick corn tortillas, and hotdogs. The days started to blend together at this point with Deb and I getting into a smoother rhythm. The photo above is of Me, Ana, and Deb. As an interpreter, one is only supposed to interpret exactly what the doctor says to the patient and what the patient says to the doctor. Typically, no small chat is allowed or paraphrasing. However, as Deb and I did breast and pelvic exam for each patient, I began jumping the gun with the same questions we would ask each patient:
How old are you?
How many kids do you have? **
When was your last period and how long did it last?
Are you sterilized? If yes, how?
Are you using some type of birth control and if so, what kind?
When was your last pap smear?
Have you had a breast exam before?
Are you married?
Are you having sexual relations with only one partner?
Also, Deb let me go ahead and educate the patient about doing self-breast exams while Deb did the breast exam. We ran into less than ten women who had had a breast exam before and even fewer who had had a mammogram. Any women that had a mammogram also had a history of suspicious cysts or lumps.
Any questionable lumps or pain were checked by Salvador, a radiologist from El Salvador who volunteered his time to help us at the clinic. It was such a blessing to have him there, especially since the women would have to wait anxiously for an appointment to get an ultrasound.
**Note based on our observations of the women we saw: We never asked women over 20 yrs old if they had kids. The question was always how many. Probably no more than 10 women that we saw had only one kid. There might have been 3 that were under 30 with no kids. Most had 3 or more kids with the max being 15.
Cultural note about being acompañada: Getting married is beyond many couples price range. They have to get married first by the law with a license, and then by the church. Thus, most couples make a verbal and permanent commitment to each other that is well-respected as a marriage though they will say they are “acompañada” or accompanied instead of married.
Just to make those who are reading hungry, lunch was a delicious bean and beef (we think the meat was beef?) soup with a soft, spongy white cheese( queso de mantequilla, dice la cocinera), thick corn tortillas, and avocado, of course.
During a brief break after our 3 PM PAP smear deadline, Deb and I noticed a policeman walking around the compound with a loaded gun. Apparently, there has been a need for more security for the local Health Promoters and for Sister Susan.
Later in the day, Kathy came in while we were doing a breast exam and said they were sending over a 16 year old new mother from peds with her 1 month old newborn. She had some concerns about intense lower abdomen pain, discharge, and whether her stitches from the birth were infected. It brought tears to my eyes to interpret for her while I held her baby because she was in so much pain during the exam. Luckily, he stayed asleep for the most part while the warmth of the baby left my scrub top damp with sweat. Deb diagnosed her with an infection in the uterus and prescribed some antibiotic from our pharmacy. As I handed the baby back to the girl, it seemed like she didn’t know what to do with it.
That shy 16 year old girl would leave a lasting impression in my mind. She seemed such a young 16 years. I felt numbed out as we did a few more breast exams and then cleaned up for the day. The clinic as a whole saw over 350 patients on this day.
I finished the day with finally getting a quick email out to the family and helping one of the nuns who runs the retreat house send an email with an attachment. I never thought I would do that.
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